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DRUGS FOR TAKE A Practical Guide to Prescribing on Day 1! Dr. Anna Crown
OBJECTIVES Identify sections of the drug chart Prescribing abbreviations When not to prescribe Use of the BNF Use of hospital protocols Prescribe common / emergency Rx
THE DRUG CHART FRONT –Patient details –Allergies –Once only medication –Drug doses omitted
THE DRUG CHART MIDDLE –Regular medication BACK –As required medication
ABBREVIATIONS Route of administration Timing
WHEN NOT TO PRESCRIBE Prescribing is not the answer You need to do something else first You could do more harm than good You feel it is not appropriate
USE THE BNF & HOSPITAL PROTOCOLS Useful things in the BNF Hospital protocols
SIMPLE REMEDIES FOR MINOR PROBLEMS Nausea Constipation Cough Indigestion Leg cramps Insomnia Agitation
TACKLING PAIN Regular analgesia Regular paracetamol Regular co-codamol 30:500 NSAIDS Morphine Other pains
JUGGLING BLOOD SUGARS Highs and lows Type 1 or Type 2? Adjusting insulin doses Sliding scales
AVOIDING PROBLEMS WITH ALCOHOLICS Enforced abstinence Forced feeding Wernickes encephalopathy: thiamine DTs Excess sodium Hypoglycaemia Seek advice
SCARY SITUATIONS What if you get there first? Additional management OSCEs Doses IV or IM
SCARY SITUATIONS Respiratory depression & pinpoint pupils Severe heart failure Myocardial infarction Severe asthma Hypoglycaemia Possible meningococcal disease Anaphylactic shock Status epilepticus
SUMMARY - 1 The drug chart Prescribing abbreviations When not to prescribe The BNF Hospital protocols Simple remedies for minor problems
SUMMARY - 2 Pain Diabetes and the drug chart Avoiding problems with alcoholics Scary situations
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